This book addresses a variety of ethical issues that arise in the care of oncology patients. Many volumes have been written on medical ethics in the past 30 years. However, few have focused on ethical issues specific to the care of cancer patients. This book brings together such a focused examination. The contributors are experienced clinicians, ethicists, medical humanists, and medical educators. The issues raised have direct relevance to the care of oncology patients in treatment as well as research settings. The chapters address issues that are central to contemporary medical practice and medical ethics inquiry. Any practicing clinician will be well aware of the problems of communication and how uncertainty, cross-cultural issues, and religious influences can impact patient care. The limits of care and the role of advance directives and palliative care are common issues that must be addressed in treating patients at the end of life. For oncologists and oncology patients, participation in clinical trials may be a thomy topic, especially when phase I clinical trials are being considered. The impact of managed care and reimbursement issues cannot be avoided in the contemporary patient care and similarly cannot be neglected when considering the ethical ramifications raised. No discussion of ethics in oncology can be complete without attention to the specific challenges raised by the pediatric patient with cancer. All of these topics are explored by the contributors to this book
1. Physicians and Cancer Patients: Communication and Advance Directives -- 2. Information is not Enough: The Place of Statistics in the Doctor-Patient Relationship -- 3. Cross-Cultural Issues in Caring for Patients with Cancer -- 4. Religious/Spiritual Concerns in Caring For the Cancer Patient -- 5. Are there Limits to Oncology Care? (Futility) -- 6. Role of Palliative Medicine in Cancer Patient Care -- 7. Informed Consent, The Cancer Patient, And Phase I Clinical Trials -- 8. The Ethical Lessons of Managed Care Applied to Clinical Trials -- 9. Kids and Cancer: Ethical Issues in Treating the Pediatric Oncology Patient -- 10. Does Reimbursement Affect Physician Decision Making?